Ressecção de pólipo nasofaríngeo inflamatório em conduto auditivo de felino doméstico: relato de caso / Resection of inflammatory nasopharyngeal polyp in ear canal of domestic feline: case report

Uma fêmea de felino doméstico foi encaminhada a um hospital veterinário particular da cidade de Guarujá (SP), Brasil, com a queixa de um aumento de volume em região de pavilhão auricular. Durante a inspeção, foi constatado que a formação peduncular tinha origem no interior da orelha, que somado ao histórico da paciente, suspeitou-se de um pólipo nasofaríngeo inflamatório. Foi feita a excisão e envio do material para exames patológicos que confirmaram a suspeita.(AU)

A female domestic cat was referred to a private veterinary hospital in the city of Guarujá-SP, Brazil, with the complaint of an increase in volume in the region of the ear. During inspection, it was found that the peduncular formation originated inside the ear, which added to the patient's history, suspected an inflammatory nasopharyngeal polyp. Excision was performed and the material was sent for pathological examinations that confirmed the suspicion.(AU)

Pólipo fibroepitelial atípico em córnea de um cão Lhasa Apso / Atypical fibroepithelial polyp in the cornea of a Lhasa Apso dog

Background: Fibroepithelial polyps are benign tumors of mesenchymal and ectodermal origin. Regarding the localization related to the cutaneous region, they may affect the eyelid and periocular area. In veterinary medicine, polyps located in the urethra of dogs and monkeys, vagina of bitches and on the skin have been described. Fibroepithelial polyps may present as single to multiple nodules, exophytic to pedunculated, usually arising on a smooth surface of a common base. The aim of this paper is to describe the ocular and histopathological changes of a corneal fibroepithelial polyp of recurrent character in a dog. Case: A 20-year-old Lhasa Apso dog, with a history of progressive corneal neoformation in the right eye for 4 months. Patient was submitted to routine ophthalmic evaluation. At biomicroscopy, a discrete mucopurulent discharge was observed in the nasal corner, a nodule in the lower eyelid (± 3 mm), moderate conjunctival hyperemia, vascularization and corneal edema between 12 and 5 h, presence of a pinkish proliferative mass in 3 h, affecting the anterior stroma and opacity of the lens, Schirmer's Tear Test (STT) 20 mm/min and intraocular pressure (IOP) 10 mm/Hg. In the left eye, the STT and IOP were within normal range (17 mm/min and 11 mg/Hg, respectively) and at biomicroscopy only lens opacity was observed. Given the presence of the neoformation in the cornea, the patient underwent lamellar keratectomy to excise the mass and third eyelid flap. The tissue was then submitted to histopathology. The histopathological examination showed a proliferation of fibrous component with areas presenting reactive fibroblasts, with acidophilic cytoplasm and with little volume and slight neovascularization, presence of hyperplasia of the lining epithelium and cells with round to oval nuclei, with inconspicuous nucleoli, compatible with fibroepithelial polyp, without evidence of malignancy. After 18 months, the patient presented recurrence of the condition with a history of slow evolution (about ten months). The ophthalmic evaluation showed lesions very similar to the initial one, describing a recurrence of the lesion. Discussion: Corneal neoplasms are uncommon in dogs. The clinical findings in patients with ocular neoplasms include irregular to nodular masses, gray to reddish in color, and typically associated with a vascular supply. These features are related to the type of tumor and its degree of evolution. There are reports in the literature of ocular neoplasms such as squamous cell carcinoma, papilloma, melanocytoma, fibrosarcoma, hemangiosarcoma, melanoma, lymphoma. Related to fibroepithelial polyp with ocular involvement, there are rare reports in human literature and none in veterinary medicine. There is a human description of the presence of a polyp affecting the cornea associated with a corneal dermoid and e other cases of polyps of conjunctival origin. As far as treatment is concerned, the polyp should be surgically removed because of the possibility of recurrence, tissue metaplasia, or even transformation into a malignant tumor, as seen in the case reported here, in which even with surgical removal there was recurrence and metaplasia of the cells. Based on the histopathological findings, it can be concluded that this is a fibroepithelial polyp with a recidivating characteristic, not well described in the veterinary literature, with an atypical presentation affecting the cornea.

Concurrent hiatal hernia and megaesophagus secondary to a nasopharyngeal polyp in a 6-month-old cat

Background: Nasopharyngeal polyps are benign and inflammatory masses assumed to arise from the middle ear or the eustachian tube with extension into the pharynx. The most common clinical signs associated with nasopharyngeal polyps include respiratory stertor, dyspnea, and otic discharge. Neurological signs, including head tilt, facial nerve paralysis, and ataxia, might indicate concurrent involvement of the middle or inner ear. The objective of the current report is to describe a case of a feline nasopharyngeal polyp with a concurrent hiatal hernia and megaesophagus, both spontaneously resolved after removal of the polyp. Case: A 6-month-old female intact domestic shorthair cat was presented for evaluation of lethargy, anorexia, and upper respiratory signs, such as stridor, stertor, and dyspnea. A thoracic radiography revealed esophageal dilation caudal to the cardiac silhouette, suggestive of megaesophagus with gaseous filtration. An esophagram confirmed a hiatal hernia and megaesophagus. Computed tomography revealed a nasopharyngeal mass adjacent to the soft palate and a soft-tissue density in the right tympanic bulla. A tentative diagnosis of a nasopharyngeal polyp was made. After the ventral bulla osteotomy, the nasopharyngeal mass was removed by a gentle traction avulsion technique. Six days after the surgery, hiatal hernia and megaesophagus were spontaneously resolved. Based on histopathologic exam, the mass was found to be an inflammatory nasopharyngeal polyp. Two months after surgery, the owner reported that the patient's condition had returned to baseline with a good appetite, and the thoracic radiography was within normal limit. Discussion: For successful treatment of a nasopharyngeal polyp, traction avulsion of the polyp with or without a ventral bulla osteotomy is recommended. However, in patients with otitis media, a ventral bulla osteotomy followed by traction avulsion of the polyp is recommended in order to reduce the rate of polyp recurrence. Common clinical signs of a nasopharyngeal polyp are stertor, stridor, dyspnea, dysphagia, and open-mouth breathing, which are identified in a chronic upper airway obstruction. A hiatal hernia secondary to a nasopharyngeal polyp has not been reported so far. However, a relationship between chronic upper airway obstruction and hiatal hernias has been proposed previously. Moreover, hiatal hernia resolved spontaneously after removal of the nasopharyngeal polyp suggests that the occurrence of the hiatal hernia was secondary to the nasopharyngeal polyp. In addition to the hiatal hernia, megaesophagus was also identified in the present case. Megaesophagus secondary to a chronic upper airway obstruction from a nasopharyngeal obstruction has been reported. However, megaesophagus is also thought to occur secondary to hiatal hernias. Therefore, in the current study, it is unclear whether the megaesophagus was solely a result of the obstructive nature of the nasopharyngeal polyp or a combination of the hiatal hernia and the nasopharyngeal polyp. In conclusion, any cat with clinical signs of an upper airway obstruction and a concurrent hiatal hernia and megaesophagus should be thoroughly investigated for a nasopharyngeal polyp, as well as other gastrointestinal and systemic causes. Furthermore, this case suggests that the prognosis for a concurrent hiatal hernia and megaesophagus is good in cats if the nasopharyngeal polyp is properly removed.

Nasal polyposis in a cow

A case report of nasal polyps in an eight year-old Tabapuã cow is reported. The cow had a history of difficulty in breathing, was euthanatized and referred for necropsy. Twenty three pedunculated neoformations were observed in the nasal cavity. Microscopically, polypoid structures were composed by swollen myxomatous stroma lined by pseudostratified columnar epithelium. Immunohistochemistry was positive for cytokeratin in the cytoplasm of epithelial cells only covering the pseudo-stratified respiratory epithelium, whereas anti-vimentin antibody was positive in the cytoplasm of cells and areas of calcification of the tunica media of blood vessels and fibroblasts within the parenchyma of the polyps. The macroscopy, histopathological, and immunohistochemical findings were consistent with nasal polyps. This is the first report of nasal polyposis in a cow in Brazil.(AU)

Nasal polyposis in a cow

A case report of nasal polyps in an eight year-old Tabapuã cow is reported. The cow had a history of difficulty in breathing, was euthanatized and referred for necropsy. Twenty three pedunculated neoformations were observed in the nasal cavity. Microscopically, polypoid structures were composed by swollen myxomatous stroma lined by pseudostratified columnar epithelium. Immunohistochemistry was positive for cytokeratin in the cytoplasm of epithelial cells only covering the pseudo-stratified respiratory epithelium, whereas anti-vimentin antibody was positive in the cytoplasm of cells and areas of calcification of the tunica media of blood vessels and fibroblasts within the parenchyma of the polyps. The macroscopy, histopathological, and immunohistochemical findings were consistent with nasal polyps. This is the first report of nasal polyposis in a cow in Brazil.

Doenças nasais e paranasais crônicas em felinos domésticos - estudo prospectivo

As doenças que afetam cronicamente o trato respiratório superior representam um problema frequente na clínica de felinos mundialmente e podem caracterizar um importante desafio diagnóstico e terapêutico. Os gatos com doenças nasais e paranasais crônicas normalmente apresentam espirros, secreção nasal, estertor respiratório e, às vezes, deformidades faciais. Esses sintomas são comuns a uma variedade de etiologias. A rinossinusite crônica idiopática (RSCI) e as neoplasias nasais são as mais frequentemente relatadas. As rinites fúngicas, pólipos nasofaríngeos, corpos estranhos nasais, estenose nasofaríngea e doenças periodontais são menos frequentes, porém importantes causas de doenças nasais em gatos. O objetivo desse estudo é realizar uma investigação para determinar a prevalência de causas etiológicas de gatos que apresentem doenças nasais e paranasais, e também comparar dados do histórico, sinais clínicos e achados radiográficos entre eles. Os gatos que apresentaram sinais de doenças do trato respiratório superior foram selecionados para coleta de dados, exame físico completo, cultura nasal bacteriológica e micológica, sorologia para Cryptococcus spp., exame radiográfico de crânio, rinoscopia e/ou rinotomia, análise histopatológica, imuno-histoquímica para FHV-1 e FCV e também PCR para Mycoplasma spp. Trinta e sete (37) gatos foram incluídos no estudo. Vinte e um (56,8%) tinham RSCI, nove (24,3%) neoplasias, três (8,1%) rinites fúngicas [Criptococose (2), Esporotricose (1)], três (8,1%) alterações estruturais [corpo estranho (1), fístula oronasal (1) e palato mole alongado (1)] e um (2,7%) pólipo nasofaríngeo. Os sinais clínicos mais comuns foram espirros (94,6%), secreção nasal (91,9%) e estertor respiratório (89,2%). Os exames radiográficos revelaram alterações de opacificação da cavidade nasal (93,9%), mais comum bilateral (66,7%), perda de definição dos ossos turbinados (84,8%) e opacificação aumentada de seios frontais (72,7%), mais frequentemente bilateral (66,7%). As associações estatísticas foram significativas entre os gatos com RSCI e o estilo de vida de casas multi-cat, secreção nasal mucopurulenta e presença de maior opacificação bilateral de seios frontais. Os gatos diagnosticados com outras doenças, que não a RSCI, tiveram associação significativa com diminuição de apetite, secreção nasal sanguinolenta, deformidades faciais e desvio de septo. A PCR para Mycoplasma spp. foi positiva em apenas um caso de RSCI e todos os gatos com RSCI tiveram resultados negativos para a análise imuno-histoquímica para FHV-1 e FCV.

Diseases that affect chronically the feline upper respiratory tract represent a frequent problem in feline practice worldwide and may characterize a substantial diagnostic and therapeutic challenge. Cats with chronic nasal and paranasal disease usually are presented with sneezing, nasal discharge, stertorous breathing and sometimes facial deformities. These symptoms are common for a variety of underlying etiologies. Idiopathic chronic rhinosinusitis (ICRS) and nasal neoplasia are the most frequently reported. Fungal rhinitis, nasopharyngeal polyps, nasal foreign bodies, nasopharyngeal stenosis and periodontal diseases are less frequently found, but are also important causes of chronic nasal diseases in cats. The objective of this study is to pursue an investigation and determine the prevalence of etiological causes for cats presenting chronic nasal and paranasal disease and also compare data from history, clinical signs and radiologic findings between them. Cats presenting upper respiratory tract disease signs were selected to perform full patient data collection, thorough physical exam, nasal bacterial and mycological cultures, Cryptococcus spp. serology, skull radiographs, rhinoscopy and/or rhinotomy, histopathological analysis, FHV-1 and FCV immunohistochemistry analysis and Mycoplasma spp. PCR. Thirty-seven (37) cats were included. Twenty-one (56.8%) had idiopathic chronic rhinosinusitis (ICRS), 9 (24.3%) neoplasia, 3 (8.1%) fungal rhinitis [Cryptococcosis (2), Sporotrichosis (1)], 3 (8.1%) had structural changes [foreign body (1), oronasal fistula (1) and elongated soft palate (1)] and 1 (2.7%) nasopharyngeal polyp. The most common signs were sneezing (94.6%), nasal discharge (91.9%) and stertorous breathing (89.2%). Skull radiographs revealed mostly bilateral (66.7%) nasal cavity opacity (93.9%), turbinate bones detail loss (84.8%) and increased frontal sinus opacity (72.7%), which was more bilateral (66.7%). Significant statistical association were made with ICRS and multicat household lifestyle, mucopurulent discharge and increased bilateral frontal sinus opacity in radiographs. Cats with diagnosed diseases other than ICRS, had significant increased prevalence of appetite loss, sanguineous discharge, facial deformities and nasal septum deviation on radiographs. Mycoplasma PCR was positive in only one case of ICRS and all 21 cases of ICRS had negative results for FHV-1 and FCV IHC analysis.

Expression of RANTES, eotaxin-2, ICAM-1, LFA-1 and CCR-3 in chronic rhinosinusitis patients with nasal polyposis / Expressão de RANTES, eotaxina-2, ICAM-1, LFA-1 e CCR-3 em pacientes com rinossinusite crônica associada à polipose nasossinusal

PURPOSE: To compare gene expression of the chemokines RANTES and eotaxin-2, its receptor, CCR-3, adhesion molecule ICAM-1 and its receptor LFA-1 in eosinophilic polyps and in control normal nasal mucosa. METHODS: Gene expression was quantified by Real Time PCR in polyps (n=35) and in healthy nasal mucosa (n=15). RESULTS: Eosinophilic polyps showed a higher expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa. CONCLUSION: Eosinophilic polyps present greater expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa.(AU)

OBJETIVO: Comparar a expressão gênica das quimiocinas RANTES e eotaxina-2, do seu receptor CCR-3, da molécula de adesão ICAM-1 e do seu receptor LFA-1 entre pólipos nasais eosinofílicos (PE) (n=35) e mucosa nasal controle (n=15). MÉTODOS: Quantificou-se a expressão gênica dos mediadores citados pela técnica de PCR em tempo real em PEs e em mucosas de concha média de pacientes sem doenças nasais ou alteração endoscópica. RESULTADOS: Pólipos eosinofílicos apresentam maior expressão de eotaxina-2 e RANTES, mas não de CCR-3, ICAM-1 e LFA-1, quando comparados as mucosas nasais controles. CONCLUSÃO: Pólipos eosinofícios apresentaram maior expressão de eotaxin-2 and RANTES, mas não de CCR-3, ICAM-1 ou LFA-1,comparada à mucosa nasal controle.(AU)

Histopatologia de lesões tumoriformes presentes na cavidade nasal de eqüídeos do Brasil

The purpose of the present study was to analyze the microscopic aspects of tumor-like masses present in the nasal cavity of equids and also to emphasize the importance of histopathological examination for determining the diagnosis. Tissue sections of tumor-like masses from the nasal cavity of 11 equids were microscopically examined. These samples were sent to the Anatomic Pathology Service of the Veterinary Medicine College from the Fluminense Federal University, Niterói, Rio de Janeiro, from 2000 to 2004. Three cases of rhinosporidiosis, one of amyloidosis, six of nasal polyps and one of progressive ethmoid hematoma were diagnosed.

Este estudo foi realizado com o objetivo de analisar os aspectos microscópicos e enfatizar a importância do exame histopatológico na determinação do diagnóstico de lesões tumoriformes na cavidade nasal de eqüídeos. Para tanto, foram estudados microscopicamente cortes de tecido de 11 eqüídeos com lesões tumoriformes na cavidade nasal. Essas amostras foram enviadas ao Serviço de Anatomia Patológica da Faculdade de Medicina Veterinária da Universidade Federal Fluminense, Niterói, Rio de Janeiro, no período de 2000 a 2004. Foram diagnosticados três casos de rinosporidiose, um de amiloidose, seis de pólipos nasais e um de hematoma etmoidal progressivo.

Histopatologia de lesões tumoriformes presentes na cavidade nasal de eqüídeos do Brasil

The purpose of the present study was to analyze the microscopic aspects of tumor-like masses present in the nasal cavity of equids and also to emphasize the importance of histopathological examination for determining the diagnosis. Tissue sections of tumor-like masses from the nasal cavity of 11 equids were microscopically examined. These samples were sent to the Anatomic Pathology Service of the Veterinary Medicine College from the Fluminense Federal University, Niterói, Rio de Janeiro, from 2000 to 2004. Three cases of rhinosporidiosis, one of amyloidosis, six of nasal polyps and one of progressive ethmoid hematoma were diagnosed.

Este estudo foi realizado com o objetivo de analisar os aspectos microscópicos e enfatizar a importância do exame histopatológico na determinação do diagnóstico de lesões tumoriformes na cavidade nasal de eqüídeos. Para tanto, foram estudados microscopicamente cortes de tecido de 11 eqüídeos com lesões tumoriformes na cavidade nasal. Essas amostras foram enviadas ao Serviço de Anatomia Patológica da Faculdade de Medicina Veterinária da Universidade Federal Fluminense, Niterói, Rio de Janeiro, no período de 2000 a 2004. Foram diagnosticados três casos de rinosporidiose, um de amiloidose, seis de pólipos nasais e um de hematoma etmoidal progressivo.

Histopatologia de lesões tumoriformes presentes na cavidade nasal de eqüídeos do Brasil

The purpose of the present study was to analyze the microscopic aspects of tumor-like masses present in the nasal cavity of equids and also to emphasize the importance of histopathological examination for determining the diagnosis. Tissue sections of tumor-like masses from the nasal cavity of 11 equids were microscopically examined. These samples were sent to the Anatomic Pathology Service of the Veterinary Medicine College from the Fluminense Federal University, Niterói, Rio de Janeiro, from 2000 to 2004. Three cases of rhinosporidiosis, one of amyloidosis, six of nasal polyps and one of progressive ethmoid hematoma were diagnosed.

Este estudo foi realizado com o objetivo de analisar os aspectos microscópicos e enfatizar a importância do exame histopatológico na determinação do diagnóstico de lesões tumoriformes na cavidade nasal de eqüídeos. Para tanto, foram estudados microscopicamente cortes de tecido de 11 eqüídeos com lesões tumoriformes na cavidade nasal. Essas amostras foram enviadas ao Serviço de Anatomia Patológica da Faculdade de Medicina Veterinária da Universidade Federal Fluminense, Niterói, Rio de Janeiro, no período de 2000 a 2004. Foram diagnosticados três casos de rinosporidiose, um de amiloidose, seis de pólipos nasais e um de hematoma etmoidal progressivo.